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NPI Code Detail

MEDICARE: FORREST B FERNANDEZ MD

MEDICARE:   FORREST B FERNANDEZ  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery PhysicianMD430199PA
22086S0102XSurgical Critical Care PhysicianMD430199PA

General Provider Information

NPI Number : 1174619969
Entity Type Code : Individual
Provider Name (Legal Business Name) : FORREST B FERNANDEZ MD
Provider Business Mailing Address
First Line : 3400 SPRUCE STREET
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-3309
Country : US
Telephone Number : 215-349-8310
Fax Number : 215-893-7270
Provider Business Practice Location Address
First Line : 3400 SPRUCE STREET
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-3309
Country : US
Telephone Number : 215-349-8310
Fax Number : 215-893-7270
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 05/21/2026

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Directions to “ FORREST B FERNANDEZ MD” Practice Location

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